In actual practice, the induction stage of closed ether is almost invariably assisted by using either nitrous oxide, or a small dose of ethyl chloride as a preliminary: these methods are described in Chapter XV. The question now arises, what _scope_ is to be assigned in modern anæsthesia, to closed-ether methods. Formerly a large proportion of anæsthesias, long or short, were conducted by the closed method, and while the greater number of anæsthetists no longer utilise them to the same extent as formerly, they may still be regarded as of the utmost value in a limited class of cases. They are speedy in action, powerful enough to overcome the most refractory patient, and with reasonable skill very safe. On the other hand, the anæsthesia obtained is not of the most desirable type. There is a great deal of salivation and mucous secretion from the respiratory mucous membranes; the respiratory movements are deeper than in open methods, from the excess of CO_{2} present in the blood, and this leads to a good deal of heaving of the abdominal wall, which may be most troublesome to the surgeon if he is opening or closing that cavity. Moreover, after their use more headache, malaise, and vomiting occur than after open-ether, and perhaps a little more tendency to bronchitis or pneumonia. For these reasons, many anæsthetists and surgeons now object to their use in abdominal surgery, though some still adhere to them for the induction stage, passing to the open method when the patient is once well under. (2) Open Ether. As already explained the strictly accurate term for this is Perhalational Ether, but so cumbersome a terminology stands small chance of general acceptance. Apparatus. The essential points in a proper outfit have already been explained (_see_ page 28) and are all well met by the mask and ether dropper introduced by Mr Bellamy Gardner (_see_ Fig. 27). The mask is covered with from twelve to sixteen layers of gauze, and lies on the gauze ring, shown in the Fig. 28A, which completes the fit between face and facepiece. The dropper fits into the ordinary six ounce dispensary bottle: the long arm dips into the ether, the short one allows air to enter the bottle to replace the ether used. A dropper can also be improvised by using a cork with slots cut at each side and with a gauze or wool wick inserted along one of these. The author finds these uncertain in their action, however: with Gardner’s dropper, a steady flow of _drops_ of ether slow or fast as required, can always be obtained once the student has acquired the knack of using the appliance. [Illustration: FIG. 27.--Bellamy Gardner’s (A) open ether mask; (B) ether dropper.] [Illustration: FIG. 28. _A._--Open ether. Ready to begin. _B._--Open ether. Condensing towel in position.] [Illustration: FIG. 28. _C._--Open ether. Correct method of holding mouth and jaw.